Abstract

Acne vulgaris (AV) is a prolonged skin disease which causes inflammatory (papules, nodules, pustules, and cysts) and non-inflammatory lesions (open and closed comedones).

The treatment of menopausal acne can be challenging as the occurrence of acne in this age group causes psychosocial damage and upsets the quality of life. There is an inclination to relapse, hence maintenance treatment is important. The choice of treatment depends on the etiology and severity of acne, response to previous treatment, skin type, and related features. Topical therapies must be taken with care as they can cause dryness and irritation in older women, who at present have dry sensitive skin.. 

Case report

A 58-year-old woman came with facial comedonal AV of the face and neck, and complaints of dull skin tone and disappointment with her overall facial look. At the time of her first visit, cryotherapy with liquid nitrogen was used to treat 15 facial actinic keratoses (AK).

She was recommended tretinoin lotion, 0.05% for acne, and instructed to apply a thin layer topically to her face at bedtime and reduce vulnerable contact to ultraviolet light including sunlight and sunlamps throughout treatment with tretinoin lotion. At 1-month follow-up, her skin tone was visibly enhanced and she had less acne lesions. At her 3-month visit, there was a noteworthy perfection in her comedonal acne and a reduction in the number of new AKs. 

No treatment-related side-effects were seen. She was advised to continue treatment with tretinoin lotion 0.05% and the progress will continue to be monitored. The patient was taught to continue avoiding unprotected exposure to ultraviolet light and counselled to contact if she developed any symptoms.

Discussion

We define a case of acne in a post-menopausal woman cured with a novel tretinoin lotion 0.05%. The patient also had some actinic keratoses, which are hyperkeratotic, scaly lesions caused by prolonged exposure to ultraviolet radiation. These lesions have the ability to progress into squamous cell carcinoma. AK can happen in patients as young as 20 years, but are more common in patients aged 50 years and older. Topical retinoids are suggested as monotherapy in comedonal acne.

Conclusion

Tretinoin lotion 0.05% comprises micronized tretinoin particles together with skin hydrating ingredients: sodium hyaluronate, soluble collagen, and glycerin in a polymeric mesh matrix.

Tretinoin lotion 0.05% seemed to be effective and well-tolerated in the treatment of comedonal acne in this post-menopausal patient. None of the commonly perceived barriers to the use of retinoids such as skin irritation, dryness, peeling, and sensitivity were observed in this patient. 

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